Getting back into my writing will be a long road, I imagine, but for now I hope to fill this blog with any fragments of decent prose that I can produce. Here is an extract from a short debate I had with one of my friends recently. In 2010, the New Zealand government put $8 million of funding towards bariatric surgery. This friend proposed a somewhat misguided opposition to the funding of obesity surgery in New Zealand. See the following:
$8 million in 2010 to fund an extra 300 weight-loss operations.
Correct me if I am wrong, but isn’t this like funding lung surgery for pack-a-day smokers?
Surely that money would have been better off in prevention schemes so that our populations would not get to this point in the first place? I know too many people who would simply eat healthier if they could afford it… why not reduce the tax of fruit and vege and let the 8million cop the difference? Surely that would help more than 300 people..?
Prevention is better than cure, J, but funding this is the most cost-effective intervention for obesity to date. Cures for obesity are few and grossly ineffective, that is, aside from obesity surgery. Dieters, for example, succeed at a despairingly low rate, and even then relapse in the majority of cases.
Now if you want to save the government money to place in other worthwhile areas , this is a good place to start. Following a gastric bypass (the gold standard) an obese patient’s diabetes resolves within 3 days, with a resulting dramatic reduction in their future risk of ischaemic heart disease, end-stage renal failure, peripheral neuropathies, diabetic retinopathy, peripheral vascular disease, and fatty liver. These reductions in risk are then consolidated by the weight loss over the following months. So in this patient’s foreseeable future we are avoiding the enormous costs of (respectively): cardiac stenting or bypass surgery; dialysis or kidney transplant; ongoing diabetic foot care; laser photocoagulation for retinopathy; and amputation once the extremities become sufficiently compromised. To name a few.
Now I do agree with your notions around the so-called ‘Fat Tax’, but 8 million invested in this will have an almost negligible impact on obesity. The cuts to healthy food would need to be far more drastic to encourage poorer families to choose this diet over the cheaper fast food and sugar-sweetened drinks. You also must understand that in a great many cases, the overeating is near pathological. Obesity is an illness, and it is unwise to view it as simply a poor lifestyle choice. Just like smoking, food has addictive qualities. The environment does play a significant role in determining how these people eat, but until we can make major reforms, we should devote some money to helping those who have ended up in this state of health due to the excess caloric availability in our developed society.
Hmmm… I understand what you are saying and I agree that it is unfortunate that there are people in NZ (and the rest) who do suffer as a result of the current health/govt system. I am sure it is nice to be one of the very few obese people in NZ to have received this surgery and are still alive as a result. However, I would say that helping 300 people is just as negligible considering at least 20% of our population suffer from obesity. It seems to me that turning to money/surgery as the answer is, if anything, reducing the need/desire for obese people to try and lose the weight themselves if they can just sit on a waiting list for an operation.
While it may be cheaper for citizens of the USA to buy fast food than to buy fresh ingredients, I dont think that the same can be said for NZ. [My partner] and I have managed to exist in Christchurch on a healthy diet which cost us no more than $25 each per week for 40 of 52 weeks each year, over past four years. I suppose this was largely due to the environment we have lived in up until now (Studylink $170 per week and studying Health Psyc at uni).
NZ’s schemes for dealing with problems within our population seem far too short term, and this is a prime example of why we need to think further into the future.
As stated, the need/desire to lose weight is not really a factor here given that, once obese, people almost invariably cannot return to a normal BMI without surgery, regardless of motivation. Motivation to lose weight is plentiful in these people, so I wouldn’t worry about that.
The extreme of your argument though, J, is akin to investing solely in cancer research, and depriving the current cancer patients of care in order to fund this. Surely this would benefit our future citizens far more than treating those who are currently ill?
We are not simply throwing money away with this funding. In fact, we are making a sound financial investment. Patients with diabesity are a black hole for healthcare dollars. Greatly reduced heart attacks, ischaemic limbs, retinopathy, renal failure, liver disease… Treatment for their endless list of end-organ damage conditions would well exceed the $8 million that we are investing here.
And I am sure that if each crowded household in South Auckland lived on $170 per person per week they could eat mighty healthily too.
It’s certainly food for thought.